Center for Dermatologic Surgery

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

CENTER FOR DERMATOLOGIC SURGERY

Practice address

123 Western Hills Blvd
Cheyenne, WY 82009-3446

Phone

(307) 635-0226

Fax

(307) 635-1924

NPI assigned

Mar 31, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sandra K Surbrugg, MDNPI 1699742957

Title

Owner

Phone

(307) 635-0226

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WY

Enrollment records 1

Listed as

Cheyenne Skin ClinicCCN 53C0001009

Medicare certification status

ActiveFrom the Provider of Services file

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sandra K Surbrugg, MD

  • Dermatology Physician
  • Cheyenne, WY
  • NPI 1699742957
  NPD (past) Authorized official
• Julie A Neville, MD

  • Dermatology Physician
  • Cheyenne, WY
  • NPI 1427005545
  NPD
• Paul R Massey, MD

  • MOHS-Micrographic Surgery Physician
  • Boston, MA
  • NPI 1174943690
  NPD
• Nicholas Robert Love, MD

  • Dermatopathology Physician
  • Cheyenne, WY
  • NPI 1932735925
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740241595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 WESTERN HILLS BLVD",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820093446",
            "telephone_number": "307-635-0226",
            "fax_number": "307-635-1924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 WESTERN HILLS BLVD",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820093446",
            "telephone_number": "307-635-0226",
            "fax_number": "307-635-1924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR DERMATOLOGIC SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SURBRUGG",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "307-635-0226",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeanne Marie Cates, BSW CSW
• Catholic Charities of Wyoming Inc
• Dustin Cavanaugh, PHARMD, RPH
• Sheri Cazier, R.N.
• Cedars Health (Cedars Health Cheyenne Clinic)
• Central Wyoming Neuroanesthesia
• Centricare Benefits LLC
• Certified Rehab Services Inc
• Chandrasekhar Reddy Chada, M.B.B.S
• Christina Anne Chafin, CAP

• Ambulatory Surgical Clinic/Center in Cheyenne, WY
• Providers in Cheyenne, WY by specialty
• Ambulatory Surgical Clinic/Center in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.